Predicting blood flow near hepatic tumors with ultrasound to improve RF ablations

利用超声预测肝肿瘤附近的血流以改善射频消融

• 批准号: 8518027
• 负责人: Bryan E Yunker
• 金额: $ 2.97万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-01 至 2015-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8518027
• 关键词: Ablation; Affect; Algorithms; Blood; Blood Vessels; Blood flow; Cattle; Cell Death; Cirrhosis; Coagulation Process; Color; Computer software; Data; Devices; Disease; Doppler Ultrasound; Effectiveness; Ensure; Evaluation; Heating; Hepatic; Imagery; Kidney Neoplasms; Knowledge; Liquid substance; Liver; Liver parenchyma; Malignant - descriptor; Malignant neoplasm of liver; Measures; Methods; Modeling; Myocardial Infarction; Necrosis; Normal Range; Operating Rooms; Organ; Patients; Performance; Perfusion; Procedures; Process; Published Comment; Radiofrequency Interstitial Ablation; Research; Research Training; Site; Slice; Software Engineering; Stroke; Temperature; Testing; Time; Tissues; Treatment Failure; Ultrasonography; Variant; base; clinical practice; effective therapy; falls; heat injury; improved; indexing; interest; neoplastic cell; prevent; public health relevance; radiofrequency; reconstruction; response; success; tool; treatment planning; tumor; tumor eradication

DESCRIPTION (provided by applicant): [Aim The proposed research is intended to increase the liver cancer tumor eradication rate of Radiofrequency (RF) ablation and increase the number of candidate patients. Relevance The local tumor eradication rate for patients with primary or secondary malignant liver tumors smaller than 3cm who are treated using Radiofrequency (RF) ablation is over 83%; unfortunately, the majority of patients have tumors larger than 3cm. The success rate of local tumor eradication of larger tumors falls to less than 50% due to unpredictable variation in the size of the thermal injury created by RF devices between different patients and even within the same patient. The success rates are limited by local blood flow carrying away the heat applied during treatment which can result in some tumor cells not reaching the cell death temperature of 55¿C and an undesired continuation and propagation of the disease. Objective The proposed research develops a new method of quantifying the amount of blood flow within a Region of Interest (ROI) surrounding a tumor using 3D ultrasound imagery. The flow information will be evaluated as a predictor of RF ablation device performance for use by clinicians during ablation planning to ensure that all of the tumor cells are destroyed and a minimal amount of healthy tissue is disturbed (critical for patients with cirrhosis). Methods Software based algorithms will be developed to reconstruct patient specific liver vessel geometry from 3D ultrasound Imagery. The associated Doppler color/velocity data from within the patient vessels will be combined with angle corrected vessel geometry to establish a "Flow Influence Index" within the ROI set around the tumor by the clinician. The index will provide an indication of the amount and direction of local blood flow. The algorithm function will be verified with an anatomically correct liver flow model of known geometry over a range of normal and pathological flow rates. The predictive capability of the algorithms will be validated by planning and performing test ablations on discarded cattle livers and comparing the planned and actual ablation sizes.]

描述（由申请人提供）： [目的 本研究旨在提高射频（RF）消融的肝癌肿瘤根除率并增加候选患者数量。相关性 小于3cm的原发性或继发性肝脏恶性肿瘤患者采用射频（RF）消融治疗的局部肿瘤根除率超过83%；不幸的是，大多数患者的肿瘤大于3厘米。由于不同患者之间甚至同一患者内射频设备产生的热损伤大小存在不可预测的差异，较大肿瘤的局部肿瘤根除成功率降至不足 50%。成功率受到局部血流带走治疗过程中施加的热量的限制，这可能导致一些肿瘤细胞未达到 55°C 的细胞死亡温度以及疾病的不期望的持续和传播。目的 本研究开发了一种使用 3D 超声图像量化肿瘤周围感兴趣区域 (ROI) 内血流量的新方法。流量信息将被评估为射频消融设备性能的预测因子，供临床医生在消融计划期间使用，以确保所有肿瘤细胞都被破坏，并且最少量的健康组织受到干扰（对于患有以下疾病的患者至关重要） 肝硬化）。方法 将开发基于软件的算法，以根据 3D 超声图像重建患者特定的肝血管几何形状。来自患者血管内的相关多普勒颜色/速度数据将与角度校正的血管几何形状相结合，以在临床医生在肿瘤周围设置的 ROI 内建立“流量影响指数”。该指数将指示局部血流的数量和方向。该算法功能将通过在正常和病理流速范围内已知几何形状的解剖学上正确的肝脏血流模型进行验证。算法的预测能力将通过规划和对废弃牛肝脏进行测试消融并比较计划和实际消融大小来验证。]